PEIA premiums won’t go up, benefits won’t go down, board says

CHARLESTON, W.Va. -- State employees, teachers, and other employees insured by the Public Employees Insurance Agency won't pay higher health insurance premiums in 2013 and -- thanks to a $4 million cash infusion from the governor's office Thursday -- won't have any reductions in benefits.

That means the PEIA Finance Board was able to approve a 2013-14 benefit plan Thursday without a proposed increase in out-of-pocket maximum co-payments for family coverage, and without an increase in co-pays on specialty medications.

Board member Josh Sword, who represents education employees, called the governor's decision "courageous."

"He's coming to us today with a $4 million guarantee to say, "Please help public employees out," Sword said of Gov. Earl Ray Tomblin.

Judy Hale, president of the West Virginia Federation of Teachers, said it is very important that the Tomblin administration assured there will be no increases in health insurance costs for teachers and public employees next year.

"We're working without a pay raise this year, and we felt it was extremely important that PEIA be left the same," she said.

Acting Administration Secretary Ross Taylor, who serves as chairman of the PEIA Finance Board, said Tomblin notified him of the additional $4 million of funding for PEIA, but said he was not aware if the funds will come out of budget surplus, contingency funds, or other accounts.

"He said he wanted to cover the cost to where there would be no reduction in benefits," Taylor of his discussion with Tomblin.

The new plan goes into effect July 1, 2013, but with the changes approved Thursday, it will effectively be a one-year continuation of the current benefits plan.

However, that could change with the 2014-15 plan, with projections indicating that employee premiums will need to increase by $11.7 million - a 9 percent hike.

The key savings for employees in the 2013-14 plan will that the out-of-pocket maximum for family coverage will stay at 11/2 times the single coverage amount, instead of going up to 2 times the single plan.

Because PEIA is on a sliding scale based on salary, the highest out-of-pocket maximum will stay at $3,375 a year, instead of increasing to $4,500. For a state employee with family coverage making $30,000 a year, the out-of-pocket maximum will stay at $1,650, instead of increasing to $2,200.